Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $89.13 / $151.36	Facility	26	$83.18	$89.13	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $1,122.02	Professional		$338.84	$478.63	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $138.04 / $281.84	Professional	26	$83.18	$138.04	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $812.83	Professional	TC	$251.19	$338.84	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $245.47 / $251.19	Professional		$239.88	$245.47	$251.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $87.10 / $190.55	Professional	26	$63.10	$87.10	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $588.84 / $912.01	Professional		$478.63	$588.84	$912.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $97.72 / $165.96	Professional	26	$95.50	$97.72	$165.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $489.78 / $724.44	Professional	TC	$380.19	$489.78	$724.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $125.89	Professional		$72.44	$107.15	$125.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $1,122.02 / $3,981.07	Professional		$446.68	$1,122.02	$3,981.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $158.49 / $426.58	Professional	26	$83.18	$158.49	$426.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $912.01 / $2,754.23	Professional	TC	$309.03	$912.01	$2,754.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $616.60	Professional		$32.36	$33.11	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $776.25 / $1,096.48	Professional		$354.81	$776.25	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $138.04	Professional	26	$79.43	$93.33	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $676.08 / $977.24	Professional	TC	$263.03	$676.08	$977.24